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Thematically, a "honky tonk woman" refers to a dancing girl in a western bar who may work as a prostitute; the setting for the narrative in the first verse of the blues version is Memphis, Tennessee: "I met a gin soaked bar-room queen in Memphis", while "Country Honk" sets the first verse in Jackson, Mississippi: "I'm sittin' in a bar, tippin' a jar in Jackson".
The band initially recorded the track called "Country Honk", in London in early March 1969. Brian Jones was present during these sessions and may have played on the first handful of takes and demos. It was his last recording session with the band. The song was transformed into the familiar electric, riff-based hit single "Honky Tonk Women" sometime in the spring of 1969, prior to Mick Taylor's joining the group. In an interview in the magazine Crawdaddy!, Richards credits Taylor for influencing the track: "... the song was originally written as a real Hank Williams/Jimmie Rodgers/1930s country song. And it got turned around to this other thing by Mick Taylor, who got into a completely different feel, throwing it off the wall another way." However, in 1979 Taylor recalled it this way: "I definitely added something to Honky Tonk Women, but it was more or less complete by the time I arrived and did my overdubs."
At the time of its release Rolling Stone magazine hailed "Honky Tonk Women" as "likely the strongest three minutes of rock and roll yet released in 1969". It was ranked number 116 on the list of Rolling Stone's 500 Greatest Songs of All Time in April 2010. The song was later put into the track listing for the video game Band Hero.